As Helen has to most current last Focus and Radial Extracorporeal Shockwave from Storz Medical is it interesting to read how the use of Shockwave has been evolving  Helen and her colleagues, here is Stuart with Joe Clarke  Rio Gold Medallist with shockwaves

Helen, Stuart, James and Beony with other physiotherapists had their second visit to Storz medical in November last year. We were further updated and trained in the use of other more advanced equipment by Storz medical.

James Woledge Osteopath

Episode 6 – Shockwave Therapy for Myofascial Pain with Orthopaedic Surgeon Dr Carlo Di Maio

Radial shockwave Therapy If the first-generation pressure wave devices which was developed in the late 1990s. Radial shockwave therapy contrast to the traditional focus shockwave therapy as it spreads more widely over the muscles and tissues. Focus shockwave therapy is about a hundred times higher and the pulse duration of the focus way being 1000 times shorter. Nowadays, both focus shockwave therapy and radial shockwave therapy have been clearly demonstrated to be most useful in the treatment of several musculoskeletal disorders.Over the years, many randomised controlled studies have proven the effectiveness and safety of musculoskeletal shockwave therapy. Therefore shockwave therapy has currently to be addressed in the scientific best verified treatment modalities for several musculoskeletal disorders including overload injuries in athletes.

Shockwave therapy is a conservative treatment modality which is still growing interest in musculoskeletal disorders in modern musculoskeletal shockwave therapy it is divided into focus and radial technology and the physical differences are about 100 fold with respect to the applied energy. Most conditions to be treated are easy to reach and clinically focus plays a major role today treatment parameters like the number of sessions are changing and further research and data will be being collected

Here is Medial Tibial Stress Syndrome being treated by Helen however it is important to know that Helen attends courses on the rehabilitation of MTSS with our world class lecturers on the management of these Injuries  by Tom Goom and Beony Mathews with Glenn Robbins as one must look at these treatments as an adjunct to quality Rehabilitation

Shockwaves therapy today is now increasingly used by our professional sports clubs as part of their exercise and sports rehabilitation and strengthening and conditioning.

One of the reasons is that certain injections such as corticosteroid injection have shown to have short-term effect in reducing pain and may in fact cause weakening of the connective tissue.

Shockwaves in contrast do have a temporary reduction in pain and also has a passive range of movement increase after treatment but the increasing evidence shows that it actually strengthens the connective tissue in combination with rehabilitation and exercises

Shockwaves therapy was introduced into sports medicine and competitive sports over 20 years ago. Today it is used in many countries not even in Europe but around the globe, over the years, many randomised controlled studies have proven the effectiveness and safety of both focus shockwaves and radial pressure ways for the treatment of several musculoskeletal disorders. The following success stories from the shockwave users from all over the world show why shockwave therapy is a well accepted and popular among athletes today.

As shockwave therapy is undergoing a major change and there are greater possibilities being opened up so increasingly shockwave therapy has become a bigger part of many practices in Germany. If you look at the physics behind shockwaves it quickly becomes clear that only the focus need results in true shockwave. Focus shockwaves are acoustic waves that are characterised by high pressure amplitude and an abrupt increase in pressure as compared with the ambient pressure. By comparison the radial shockwave is, from a physics point of view, a pressure wave whose pulse duration is 1000 times longer and the peak pressures are between 10 to 20 times lower then focus shockwaves. The use of focus shockwaves is more pleasant in some respects for the patient for example there is a lower noise and much less pain during treatment – particularly for tendon opposite the near the enthesis such as tennis elbow or radial epidocondylopathy or insertional achillodynia

Focus shockwave therapy has its preferred treatment for deep-seated treatment regions such as the shoulder, lumbar facet joints, gluteal muscles piriformis, hip joint hamstrings, calf muscles, and plantar fasciitis

Focus shockwave is also the preferred treatment for conditions close to the bony treatment areas as it is more gentle and kind of close to the bone for example  Shin Splints Tennis Elbow insertional Achillies Tendinopathy

Conditions which are close to the bone which are better known as non-infected inflammations of the pubis symphysis, the os pubis and surrounding structures like adductors. abdominal muscles and fascias

While this conditions are mostly me due to overload, dysbalance, intensive training with pain when walking, going up and down stairs standing on one leg and pain on many other functional tests.  The noninfective inflammations can be so intense that slow progressive rehabilitation becomes increasingly frustrating and delays in time and waiting for the inflammations to ease before quality rehabilitation can progress to a healthy level of return to sport or return to running.     Injection Therapies can be expensive and short term only without the effects of strengthening the connective tissue to prevent re-injury patterns creeping back in

Here is a Peroneal Tendinopathy being treated with Focus Shockwave Therapy

Here is a recent blog on Tom Goom Running Physio by Beony Mathews on Focus and Radial Shockwave Therapy on achilles Tendinopathy